Kaila Venezia, a community social worker with the Pittsburgh Public Safety Department and the City of Pittsburgh Office of Community Health and Safety, and Pittsburgh Fire Bureau Lt. Chad Hirosky, respond to a call as part of the city’s High Utilizer Program on Thursday, July 27, 2023, in Lawrenceville. (Photo by Stephanie Strasburg/PublicSource)
Patients relying on 911 as their primary provider have been a forgotten demographic, but a team headed by Pittsburgh’s Fire Bureau and including medics and social workers is trying to get to the roots of patients’ emergency calls.
by Elizabeth Szeto, PublicSource
A 45-year-old woman with anxiety called 911 28 times with the exact same narrative.
A 60-year-old man with rib pain but without a known medical diagnosis made a “big block of calls” for the same issue repeatedly, as did a woman with repeated falls stemming from shortness of breath.
— summaries of cases presented at the June 23 meeting of Pittsburgh Bureau of Fire High Utilizers Program team
Over two dozen cases like these are reviewed weekly by Pittsburgh Fire Bureau Lt. Chad Hirosky and a small group of fellow firefighters, sometimes allied with city medics and social workers. Together, they form a team of City of Pittsburgh employees making weekly trips around the city, meeting patients one-on-one and forming relationships with them that last anywhere from several days to many months.
Their target patients: “high utilizers.”
The term describes people who have unmet medical and daily living needs posing barriers to their wellness who rely on 911 for care.
The team links high utilizers to available services and supports them until they’re ready to accept the help.
As most high utilizers live on their own, their predicament goes largely unseen. “Often, these cases get resolved through mortality, unfortunately, over time and nobody notices. But it’s very reflected within the 911 call list,” said Hirosky, who has been the High Utilizer Program’s developer since the unit was envisioned around 2016 and began operating in 2020.
PublicSource obtained data from Allegheny County on 911 calls often associated with high utilizers from 2015 to April of this year.
Calls to 911 associated with high utilizers make up around 10% of overall emergency calls, but Hirosky and his collaborators view them as opportunities to identify and address people’s problems.
While quality and longevity of life are most important, the cost of excessive 911 calls is also significant.
An ambulance ride costs a minimum of $325 for basic life support and $400 for advanced life support (ALS) services, but fees vary by distance traveled and the level of care provided en route. While they can be costly, 911’s accessibility and quick response time makes it an easy answer to people’s cries for help.
“911 is the lowest barrier of access to help, period,” said former EMS Community Paramedic Crew Chief John Mooney in an interview, prior to leaving the city’s employ. “It’s not a great tool for a lot of problems – but it’s an easy one to reach for.”
Hirosky said the most common patients the unit sees are single women in their mid-60s, split almost evenly between Black and white residents.
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